Strategies to reduce transfemoral access complications in contemporary interventional cardiology

Vascular access site complications due to transfemoral access (TFA) for cardiac procedures are common because patients who receive femoral access are more complex. Furthermore, TFA-related vascular access site complications are associated with substantial excess morbidity. An updated narrative review is warranted because technique, technology, and knowledge have rapidly progressed in the past decade. We review pre-procedural (transradial [TRA] first approach and risk factors), procedural (ideal cannulation site, ultrasound [US] guidance, micropuncture needle, femoral angiography, and sheath size), and postprocedural (vascular closure devices) considerations to reduce vascular access site complications.